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26 Cards in this Set
- Front
- Back
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The best approach to improve resolution in the near field of a 2D ultrasound image is:
A) Increase gain B) Decrease power output C) Increase transducer frequency D) Decrease dynamic range E) Narrow the 2D sector |
C - Increase transducer frequency
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The best approach to improve the resolution of a structure at a depth of 9 to 10 cm from the transducer is:
A) Increase gain B) Decrease power output C) Increase transducer frequency D) Decrease dynamic range E) Narrow the 2D sector |
E - Narrow the 2D sector
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What is the most appropriate Doppler modality for clinical evaluation of left ventricular diastolic inflow?
A) Pulsed Doppler B) Continuous Wave Doppler C) Color Doppler |
A - Pulsed Doppler
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What is the most appropriate Doppler modality for clinical evaluation of the direction of MR jet?
A) Pulsed Doppler B) Continuous Wave Doppler C) Color Doppler |
C - Color Doppler
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What is the most appropriate Doppler modality for clinical evaluation of aortic stenosis velocity?
A) Pulsed Doppler B) Continuous Wave Doppler C) Color Doppler |
B - Continuous Wave Doppler
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What is the most appropriate Doppler modality for clinical evaluation of pulmonary vein flow velocity?
A) Pulsed Doppler B) Continuous Wave Doppler C) Color Doppler |
A - Pulsed Doppler
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What is the most appropriate Doppler modality for clinical evaluation of TR velocity?
A) Pulsed Doppler B) Continuous Wave Doppler C) Color Doppler |
B - Continuous Wave Doppler
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Which one of the following would be the best initial approach for increasing the frame rate with color doppler flow imaging?
A) Decrease depth B) Widen color sector C) Shift color baseline D) Decrease color velocity scale E) Use smaller height color box |
A - Decrease depth
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List 4 things that can be adjusted in order to improve a doppler waveform display.
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1) Scale
2) Gain 3) Baseline 4) Wall Filter |
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In a 23 year old asymptomatic man referred for echocardiography for evaluation of a murmur, MV anatomy is normal but MR is detected with a vena contracta width of 2 mm and a faint holosystolic signal on CW doppler. The most appropriate comment regarding this finding is:
A) Normal finding B) Endocarditis prophylaxis is indicated C) Additional evaluation with quantitation of regurgitant orifice area is needed D) Recommend repeat echocardiogram in 1 year E) TEE should be considered |
A - Physiologic amount of MR indicated by narrow vena contracta and weak CW signal
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A 68 year old man is referred for stress echocardiography to evaluate for CAD prior to elective knee replacement. He has cardiac risk factors of hypertension and hypercholesterolemia. His ECG shows a LBBB. Based on this evaluation, you recommend:
A) No stress test B) Treadmill ECG stress test C) Bicycle echo stress test D) Dobutamine echo stress test E) Coronary angiography |
D - Dobutamine echo stress test
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TTE images of the LV are suboptimal in an obese 62 year old woman referred for baseline measurement of LV EF prior to cardiotoxic chemotherapy. The next best step in diagnosis is:
A) Intravenous agitated saline B) Left heart contrast C) TEE D) LV angiography E) Radionuclide angiography |
B - Left heart contrast
(second choice = E, radionuclide angiography) |
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What is the best initial approach to use in evaluation of prosthetic MR?
A) TTE B) TEE C) Agitated saline contrast D) Left heart contrast E) Stress echo F) 3D echo G) Intracardiac ultrasound H) Intravascular ultrasound |
B - TEE
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What is the best initial approach to use in detection of PFO?
A) TTE B) TEE C) Agitated saline contrast D) Left heart contrast E) Stress echo F) 3D echo G) Intracardiac ultrasound H) Intravascular ultrasound |
C - Agitated saline contrast
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What is the best initial approach to use in detection of CAD?
A) TTE B) TEE C) Agitated saline contrast D) Left heart contrast E) Stress echo F) 3D echo G) Intracardiac ultrasound H) Intravascular ultrasound |
E - Stress echo
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What is the best initial approach to use in monitoring of percutaneous ASD closure?
A) TTE B) TEE C) Agitated saline contrast D) Left heart contrast E) Stress echo F) 3D echo G) Intracardiac ultrasound H) Intravascular ultrasound |
G - Intracardiac ultrasound
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What is the best initial approach to use in evaluation for possible pericardial effusion?
A) TTE B) TEE C) Agitated saline contrast D) Left heart contrast E) Stress echo F) 3D echo G) Intracardiac ultrasound H) Intravascular ultrasound |
A - TTE
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A 36 year old man with a known bicuspid AV presents with fever and malaise for 2 weeks. His cardiac physical exam is unchanged, with a soft aortic regurgitant murmur and no signs of heart failure. His ECG is remarkable only for LVH. Blood cultures are pending. TTE shows no valvular vegetations with excellent image quality. The most appropriate management strategy at this point is:
A) Await blood culture results B) Schedule a repeat echo in 2 weeks C) TEE D) Stress echo E) Contrast echo |
A
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A 24 year old pregnant woman is referred for evaluation of a murmur. Echo shows normal ventricular size and systolic function. Valve anatomy appears normal, but there is trace to mild MR, mild TR, and mild PR. The antegrade aortic flow velocity is 1.3 m/s, and the pulmonary artery antegrade velocity is 1.2 m/s. The most likely cause of the murmur is:
A) MR B) AS C) TR D) PS E) Flow Murmur F) No murmur is present |
E - Flow murmur (normal in pregnancies)
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A 28 year old man is referred for evaluation of a murmur that he says he has had all his life. On echocardiography you find a high velocity (more than 5 m/s) systolic jet of flow using CW. Aortic and mitral valve anatomy is normal, and ventricular size and systolic function are normal. The most liely cause of the murmur is:
A). Doppler artifact B) AS C) MS D) VSD E) PDA |
D - VSD
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Echocardiography is requested to evaluate for heart failure in a 64 year old man with a 3 month history of increasing dyspnea on exertion. Which of the following would NOT explain heart failure symptoms?
A) LV EF = 30% B) MS C) Aortic Anuerysm D) PA systolic pressure of 64 mmHg E) Constrictive pericarditis |
C - Aortic Aneurysm
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A 64 year old man presents with chest pain over 2 days, with more severe pain earlier today that has now resolved. His past medical history is remarkable for a 20 year history of hypertension, current smoking, and elevated cholesterol. EKG shows ST depression in the inferior leads. Echo shows an EF=63% with normal resting wall motion. Aortic root maximum dimension is 3.4 cm with antegrade flow velocity of 1.1 m/s and trace regurg. There is mild posterior mitral leaflet prolapse with mild MR. There is no pericardial effusion. The most likely cause of chest pain is:
A) CAD B) Aortic dissection C) MVP D) Acute Pericarditis E) AS |
A - CAD
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In a 62 year old man with a dilated cardiomyopathy referred for echocardiography, heart rate is 80 bpm with a blood pressure of 100/60 mmHg. Ventricular volumes, measured by tracing endocardial borders in the apical 4c & 2c views, were 180 ml in diastole and 120 ml in systole. Calculate Ejection Fraction, Stroke Volume, and Cardiac Output.
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EF = 33%
SV = 60 ml CO = 4.8 L/min |
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A 32 year old woman with primary pulmonary hypertension is referred for follow-up of her pulmonary pressures. In addition to TR jet velocity, the following information is needed to estimate pulmonary systolic pressure in this patient:
A) RV free wall thickness B) MR maximum velocity C) Imaging of the IVC D) Hepatic vein flow E) Antegrade velocity in the PA |
C
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In a patient with a congenital heart disease, the maximum TR velocity is 4.0 m/s, the antegrade velocity in the PA is 2.8 m/s, and the IVC and hepatic veins are dilated with no change in diameter with respiration. The estimated pulmonary systolic pressure is:
A) > 75 mmHg B) 50-75 mmHg C) 25-50 mmHg D) <25 mmHg E) cannot be determined |
B
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A quantitative EF has been requested for an obese patitnet with poor endocardial definition. Which of the following is most likely to be helpful for improving endocardial definition?
A) Increased imaging depth B) Lower frame rate C) Fundamental imaging D) Steep left lateral decubitus position E) Lower gain settings |
D
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